The clinical research and patient care core programs for the Northern California Comprehensive Sickle Cell Center (NCCSCC) application are based in the East Bay at Children's Hospital Oakland (Project A1), and in the West Bay at San Francisco General Hospital/University of California, San Francisco (Project A-2). Because separate institutions are involved, individual budgets are presented for Project A1 and A2 in the section that follows this abstract. The large patient population enrolled in these cooperative clinical programs provides an ideal source to conduct clinical and basic research projects. The success of these interactions is reflected in our publications ( summary progress report), national efforts to establish treatment guidelines for patients and in our contribution to understanding the etiology and mechanism of sickle cell clinical complications. In addition to the detailed projects proposed there are several core projects including l) iron overload in SCD; 2) new anti-sickling rx, [Gardos channel inhibitor, hydroxurea and rag] 3) umbilical cord collection and transplantation; 4) genetic risk factors for stroke (I-ILA, chlamydia); and 5) nitric oxide/arginine therapy. In addition to the above projects, the core will provide necessary patients and/or samples for many basic and clinical projects funded in the center. In summary, the strength of the clinical core in our center application will enable us to complete successfully the proposed clinical research projects, participate in basic research and improve the understanding of the etiology and treatment of many sickle cell complications.